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Abstract :
[en] PET-CT combines in a single imaging session both anatomical and metabolic information. Depending on the strategy, the CT part of the study may yield only crude anatomical information and attenuation correction for the PET part, or it may offer full radiological diagnostic features. Regarding the radiotracers for gastrointectinal oncology, FDG remains the mainstay but alternative compounds aimed at more specific biological targets are actively tested. In particular Ga-68-labelled DOTA derivatives image somatostatine receptors with exquisite sensitivity and specificity. In clinical practice, several indications are well recognized for FDG PET-CT. These include the initial staging of esophageal, pancreatic and rectal cancers with a clinical impact in a significal proportion of patients. The metabolic activity, as recorded prior to any treatment, holds prognostic information in esophageal and rectal cancers, as well as GISTs. Methodological issues remain to be solved, but the potential is clearly present so that an increased clinical role is highly likely in the near future. FDG PET-CT is a major clinical tool in the detection and staging of recurrent colorectal cancer, and for determining the resectability of liver metastases. Ongoing developments include technological advances, in particular the combined PET-MR devices, and alternative tracers, such as those imaging angiogenesis.